# Third-Generation Trabecular Micro-Bypass Implantation and Phacoemulsification in Patients with Glaucoma: A Multicenter Study

**Authors:** Mitchell Shultz, Zachary M. Vest, Valerie Trubnik, Steven R. Sarkisian, Dana M. Hornbeak

PMC · DOI: 10.3390/vision9030061 · 2025-07-19

## TL;DR

A study found that combining a new glaucoma implant with cataract surgery significantly lowers eye pressure and reduces medication use.

## Contribution

Demonstrates real-world effectiveness of third-generation trabecular micro-bypass implantation combined with phacoemulsification in glaucoma patients.

## Key findings

- Intraocular pressure decreased significantly from 17.2 to 13.8 mmHg at 12 months.
- The proportion of patients off glaucoma medications increased from 16.7% to 62.5%.
- More than 90% of patients achieved an intraocular pressure of ≤18 mmHg after 12 months.

## Abstract

This multicenter study evaluated the effectiveness and safety of third-generation trabecular micro-bypass implantation (iStent® infinite) combined with phacoemulsification (n = 233 eyes). Key outcomes through 12 months included the mean change in intraocular pressure (IOP) and the number of topical medications, as well as proportions achieving IOPs ≤ 18/15/12 mmHg or using 0/1/2/ ≥ 3 medications. In all eyes with 12-month follow-up data (n = 96, consistent cohort), the mean IOP reduced from 17.2 ± 4.2 mmHg preoperatively to 13.8 ± 3.0 mmHg at Month 12 (p = 0.001), while the mean number of medications reduced from 1.24 ± 0.91 preoperatively to 0.61 ± 0.96 at Month 12 (p = 0.001). The proportions of eyes achieving IOP ≤ 18/15/12 mmHg increased from 63.5%, 34.4%, and 14.6% preoperatively to 92.7%, 71.9%, and 37.5%, respectively at Month 12, (all p = 0.001). The proportions of eyes off medication increased from 16.7% preoperatively to 62.5% at Month 12 (p = 0.001). This study provides clinically relevant, real-world results that demonstrate significant reductions in IOP and the number of topical glaucoma medications required following iStent infinite trabecular micro-bypass and phacoemulsification.

## Linked entities

- **Diseases:** glaucoma (MONDO:0005041)

## Full-text entities

- **Diseases:** Glaucoma (MESH:D005901)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Figures

4 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12286079/full.md

---
Source: https://tomesphere.com/paper/PMC12286079